Background: This study was performed to prospectively investigate the diagnostic reliability of the daily use of TIRADS classification system, in differentiating between a benign and a malignant lesion.

Patients and Methods: In this prospective observational study, 30 patients with thyroid nodules underwent ultrasound examination and fine needle aspiration. The ultrasound studies were evaluated according to the TIRADS characteristics of composition, echogenicity, margins, shape, and echogenic foci. Each feature in a particular USG characteristic was scored and ACR-TIRADS categorization done from 1 to 5. This was compared to FNAC.

Results: Of the 30 nodules included in the study, 23 were found to be benign and 7 were found to be malignant. Risk of malignancy for all ultrasound features showed an increasing trend with higher scored feature. All nodules in TIRADS 1,2 and 3 scores were benign, 1 out of 7 nodules in TIRADS 4 was malignant, all nodules in TIRADS 5 revealed malignancy. Colloid nodular goiter represented the most common benign pathology, while papillary thyroid carcinoma was the most common malignant entity.

Conclusions: TIRADS is a high specific, accurate classification system for categorizing the thyroid nodules based on ultrasound features, for assessing the risk of malignancy.

Keywords: TIRADS, Thyroid nodule imaging.